Audits and their impact on clinical practice
Tóm tắt
This paper aims to examine the impact of a number of audits on clinical practice within a large mental health NHS trust. It aims to consider all audits that had been reaudited by psychiatry trainees and to compare the adherence to various standards before and after reaudit.
The authors examined all available clinical audits undertaken by psychiatry trainees that had been reaudited within Mersey Care NHS Trust. The results were analysed using SPSS version 16.0 for Windows. Differences between the results before and after reaudit were tested for using Pearson chi‐squared and Fisher's exact tests, both two‐tailed.
Significant improvements were noted in five of the 35 standards compared before and after reaudit. Only one reaudit, that of the assessment of physical health and of metabolic and cardiovascular risk in inpatients in Ashworth Hospital, showed significant deteriorations in adherence to the standards which was seen in seven of the nine parameters.
The reaudits demonstrated only a limited improvement in practice. This highlights the need for a more structured approach to involvement of junior doctors in clinical audit and more robust methods of dissemination and implementation of recommendations.
Từ khóa
Tài liệu tham khảo
Davidson, K. and Smith, L. (1993), “Time spent by doctors on medical audit”, Psychiatric Bulletin, Vol. 17, pp. 418‐19.
Department of Health (1991), “Health circular”, Medical Audit in Hospitals and Community, Vol. 91 No. 2, Department of Health, London.
Department of Health (1999), Effective Care Coordination in Mental Health Services. Modernising the CPA, DOH, available at: www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_4057270.pdf.
General Medical Council (2006), Good Medical Practice. Guidance for Doctors, General Medical Council, available at: www.gmc‐uk.org/static/documents/content/GMC_GMP_0911.pdf.
Greenwood, J.P., Lindsay, S.J. and Batin, P.D. et al. (1997), Junior Doctors and Clinical Audit, Vol. 31, JR College of Physicians, London, pp. 648‐51.
Healthcare Quality Improvement Partnership (HQIP) (2010), “Guide to involving junior doctors in clinical audit”, HQIP, available at: www.hqip.org.uk/assets/LQIT‐uploads/HQIP‐026‐Guide‐to‐Involving‐Junior‐Doctors‐in‐Clinical‐Audit‐19‐April‐2010.pdf.
National Institute for Clinical Evidence (2002), Principles for Best Practice in Clinical Audit, NICE, London, available at: www.nice.org.uk/media/796/23/BestPracticeClinicalAudit.pdf.
NHS Centre for Review and Dissemination (1999), “Getting evidence into practice”, Effective Health Care, Vol. 5 No. 1.